National Provider Identifier [NPI]: |
1588614648 |
Last Name Of The Provider |
CHEN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
17772 BEACH BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
HUNTINGTON BEACH |
Zip Code Of The Provider |
92647 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
247 |
Number Of Medicare Beneficiaries |
215 |
Total Submitted Charge Amount |
119847 |
Total Medicare Allowed Amount |
35726.86 |
Total Medicare Payment Amount |
27011.77 |
Total Medicare Standardized Payment Amount |
25493.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
247 |
Number Of Medicare Beneficiaries With Medical Services |
215 |
Total Medical Submitted Charge Amount |
119847 |
Total Medical Medicare Allowed Amount |
35726.86 |
Total Medical Medicare Payment Amount |
27011.77 |
Total Medical Medicare Standardized Payment Amount |
25493.18 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
126 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
190 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
177 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
37 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8422 |